Glaxo Chief: Our Drugs Do Not Work on Most Patients

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Published on Monday, December 8, 2003 by the lndependent/UK

Glaxo Chief: Our Drugs Do Not Work on Most Patients

by Steve Connor

A senior executive with Britain's biggest drugs

company has admitted that most prescription

medicines do not work on most people who take

them.

Roses, worldwide vice-president of genetics

at GlaxoKline (GSK), said fewer than half of

the patients prescribed some of the most

expensive drugs actually derived any benefit from

them.

It is an open secret within the drugs industry

that most of its products are ineffective in most

patients but this is the first time that such a

senior drugs boss has gone public. His comments

come days after it emerged that the NHS drugs

bill has soared by nearly 50 per cent in three

years, rising by £2.3bn a year to an annual cost

to the taxpayer of £7.2bn. GSK announced last

week that it had 20 or more new drugs under

development that could each earn the company up

to $1bn (£600m) a year.

Dr Roses, an academic geneticist from Duke

University in North Carolina, spoke at a recent

scientific meeting in London where he cited

figures on how well different classes of drugs

work in real patients.

Drugs for Alzheimer's disease work in fewer than

one in three patients, whereas those for cancer

are only effective in a quarter of patients.

Drugs for migraines, for osteoporosis, and

arthritis work in about half the patients, Dr

Roses said. Most drugs work in fewer than one in

two patients mainly because the recipients carry

genes that interfere in some way with the

medicine, he said.

" The vast majority of drugs - more than 90 per

cent - only work in 30 or 50 per cent of the

people, " Dr Roses said. " I wouldn't say that most

drugs don't work. I would say that most drugs

work in 30 to 50 per cent of people. Drugs out

there on the market work, but they don't work in

everybody. "

Some industry analysts said Dr Roses's comments

were reminiscent of the 1991 gaffe by Gerald

Ratner, the jewelry boss, who famously said that

his high street shops are successful because they

sold " total crap " . But others believe Dr Roses

deserves credit for being honest about a

little-publicized fact known to the drugs

industry for many years.

" Roses is a smart guy and what he is saying will

surprise the public but not his colleagues, " said

one industry scientist. " He is a pioneer of a new

culture within the drugs business based on using

genes to test for who can benefit from a

particular drug. "

Dr Roses has a formidable reputation in the field

of " pharmacogenomics " - the application of human

genetics to drug development - and his comments

can be seen as an attempt to make the industry

realize that its future rests on being able to

target drugs to a smaller number of patients with

specific genes.

The idea is to identify " responders " - people who

benefit from the drug - with a simple and cheap

genetic test that can be used to eliminate those

non-responders who might benefit from another

drug.

This goes against a marketing culture within the

industry that has relied on selling as many drugs

as possible to the widest number of patients - a

culture that has made GSK one of the most

profitable pharmaceuticals companies, but which

has also meant that most of its drugs are at best

useless, and even possibly dangerous, for many

patients.

Dr Roses said doctors treating patients routinely

applied the trial-and-error approach which says

that if one drug does not work there is always

another one. " I think everybody has it in their

experience that multiple drugs have been used for

their headache or multiple drugs have been used

for their backache or whatever.

" It's in their experience, but they don't quite

understand why. The reason why is because they

have different susceptibilities to the effect of

that drug and that's genetic, " he said.

" Neither those who pay for medical care nor

patients want drugs to be prescribed that do not

benefit the recipient. Pharmacogenetics has the

promise of removing much of the uncertainty. "

Response rates

Therapeutic area: drug efficacy rate in per cent

* Alzheimer's: 30

* Analgesics (-2): 80

* Asthma: 60

* Cardiac Arrhythmias: 60

* Depression (SSRI): 62

* Diabetes: 57

* Hepatitis C (HCV): 47

* Incontinence: 40

* Migraine (acute): 52

* Migraine (prophylaxis)50

* Oncology: 25

* Rheumatoid arthritis50

* Schizophrenia: 60

© 2003 Independent Digital (UK) Ltd

http://www.commondreams.org/headlines03/1208-02.htm

Also See:

Demolished: The Myth That Allows Drugs Giants to Sell More

http://www.commondreams.org/headlines03/1208-01.htm